Chaparro M et al. – Measurement of serum anti–TNF– α trough levels and antibody titres could prove useful in therapeutic drug monitoring in inflammatory bowel disease (IBD) patients treated with anti–TNF– α agents.Methods
- A systematic review was undertaken based on electronic searches of the PubMed database from the earliest record to February 2012.
- The reference lists of all relevant articles and abstracts from meetings were also consulted.
- The authors observed a close relationship between trough levels of anti-TNF- α drug and maintenance of response to these drugs.
- The role of antibodies in loss of response seems to be limited to their effect favouring the clearance of the drug.
- The risk of infusion reactions, but not of delayed hypersensitivity reactions, is higher in patients with antibodies against the anti-TNF-α drug.
- Testing anti-TNF-α drug and antibody levels, together with clinical and endoscopic or radiological assessment, seems useful when attempting to optimise therapy and prevent inappropriate management of IBD patients.